Association between all-cause and cause-specific mortality and the GOLD stages 1–4: A 30-year follow-up among Finnish adults

Tiina Mattilae， Tuula Vasankarie， Merja Kanervistoe， Tarja Laitinene， Olli Impivaarae， Harri Rissanene， Paul Knekte， Pekka Jousilahtie， Seppo Saarelainene， Pauli Puukkae， Markku Heliövaarae

Background

Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction.

Methods

We studied the association between all-cause and cause-specific mortality and GOLD stages 1–4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980.

Results

After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06–1.51), 1.40 (1.21–1.63), 1.55 (1.21–1.97) and 2.85 (1.65–4.94) for GOLD stages 1–4, respectively, with FEV1/FVC ≥70% as the reference. The association between GOLD stages 2–4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages.

Conclusions

Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.

respiratory medicine

August 2015Volume 109, Issue 8, Pages 1012–1018

DOI: http://dx.doi.org/10.1016/j.rmed.2015.06.002 |